Clinical assessment of a new stereoscopic digital angiography system.
OBJECTIVE
To assess the clinical feasibility of an experimental modified angiographic system capable of real-time digital stereofluoroscopy and stereography in X-ray angiography, using a twin-focus tube and a stereoscopic monitor.


METHODS
We report the experience obtained in 37 patients with a well-documented examination. The patients were examined for coronary angiography (11 cases), aortography (7 cases), pulmonary angiography (6 cases), inferior vena cava filter placement (2 cases), and cerebral angiography (11 cases). Six radiologists were asked to use stereoscopic features for fluoroscopy and angiography. A questionnaire was designed to record their subjective evaluation of stereoscopic image quality, ergonomics of the system, and its medical interest.


RESULTS
Stereofluoroscopy was successfully used in 25 of 37 cases; diplopia and/or ghost images were reported in 6 cases. It was helpful for aortic catheterization in 10 cases and for selective catheterization in 5 cases. In stereoangiography, depth was easily and accurately perceived in 27 of 37 cases; diplopia and/or ghost images were reported in 4 cases. A certain gain in the three-dimensional evaluation of the anatomy and relation between vessels and lesions was noted. As regards ergonomic considerations, polarized spectacles were not considered cumbersome. Visual fatigue and additional work were variously reported. Stereoshift tuning before X-ray acquisition was not judged to be a limiting factor.


CONCLUSIONS
A twin-focus X-ray tube and a polarized shutter for stereoscopic display allowed effective real-time three-dimensional perception of angiographic images. Our clinical study suggests no clear medical interest for diagnostic examinations, but the field of interventional radiology needs to be investigated.
Moll
T
T
CREATIS, associated to CNRS (UMR 5515) and affiliated to INSERM, Service de Radiologie, Hôpital Cardiovasculaire et Pneumologique, BP Lyon Montchat, F-69394 Lyon cedex 03, France.
Douek
P
P
Finet
G
G
Turjman
F
F
Picard
C
C
Revel
D
D
Amiel
M
M
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D003867:Depth Perception / Q000502:physiology; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012372:ROC Curve; D014652:Vascular Diseases / Q000000981:diagnostic imaging*